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The geographies of health and wellbeing – by Pauline Garvey

By Laura Haapio-Kirk, on 15 August 2018

Author: Pauline Garvey

Photo (CC BY) Anna Li

Fairly frequently the Irish media focuses on the ‘downsizing dilemma’ for retirees (O’Rourke 2017), but what receives less attention is the downsizing that comes with marital breakdown. As I conduct research the frequency with which I meet men and women who are separated or divorced is striking. This observation is backed up by recent census data that reveals that separation is currently a significant aspect of life for many Irish families. The Central Statistics Office figures show a significant increase in the percentages of people who separate in the forty-plus age groups (CSO, 2016). The rate of separation peaks at age 48.

This trend in mid-life is significant because, otherwise, marital breakdown is decreasing in the general population. In fact, there was a decrease of 11,115 separated or divorced persons aged under 50 between 2011 and 2016. By contrast there was a substantial increase of 29,224 persons over the age of 50 between 2011-2016. Not only is there an age factor but there is also a gendered dimension in how people report their marital status. Lunn et al. (2009) found that more women than men report themselves to be separated. The conclusion they drew was that men who are separated are more likely to identify themselves as ‘single’ rather than ‘separated’. Also a higher rate of re-marriage by men goes some way to explaining the disparity in figures between the rate of female separation and the rate of male separation, but it also raises questions about how Irish women self-identify following separation (see Hyland 2013).

What we learn from this is that marriage separation is particularly significant for people in their 40s and 50s, that a larger proportion of women do not re-marry and think of themselves as separated rather than single. This alteration in domestic circumstances may be experienced with a mix of emotions but the people I have spoken to are keenly aware of the importance of being accessible to others as they age. This has been discussed with me as either an issue regarding physical (‘what if I fall getting out of the bath?’) or emotional wellbeing (‘my daughter knows when I’m watching Love Island and she’ll text me “he’s a wally” …so I don’t feel alone’). One woman told me of a series of health problems she encountered around the time she was due to retire. As a result of what she calls a ‘bad reaction to life’, she suffered from acute depression and was admitted to a psychiatric hospital for 6 months. On her release and return home she described the effect of having automatic text messages sent to her from the hospital as part of her treatment. The text messages that she received were automatic daily messages: ‘they sent me texts every day or every second day saying ‘how are you doing?’, ‘hope everything is ok?’. So although the messages were not personalised, she describes them as  ‘sending some positivity, it was superb to think that someone knew you weren’t well and could send a text to say you weren’t alone’. The key issue for her is that regular text messages inquiring about her health represented ‘a life line, some contact from the outside world to say we care about you and hope you are getting on alright’. 

As my research continues it is clear that while no life experience can be viewed in isolation, the geographies of age, the places that one experiences midlife, can matter a great deal. My respondents are not just well or unwell, they experience age, health, illness or wellbeing in specific places, whether that is in the privacy of their homes, public spaces or doctors’ clinics. Similarly in contrast to being single, this research causes me to consider the ways in which ‘being separated’ is relational? Should we think of separation as a geographical term, suggesting a lingering connection to place as well as to person?

 

Central Statistics Office, Ireland (2016), available online at https://www.cso.ie/en/releasesandpublications/ep/p-cp4hf/cp4hf/ms/

Hyland, L. (2013) Doing’ separation in contemporary Ireland: the experiences of women who separate in midlife, D.Soc.Sc Thesis, University College Cork, available online at https://cora.ucc.ie/bitstream/handle/10468/1179/HylandL_DSocSc2013.pdf?sequence=2&isAllowed=y

Lunn, P., Fahey, T. and Hannan, C. (2009) Family Figures: Family Dynamics and Family Types in Ireland, 1986-2006, Dublin: ESRI and UCD.

O’Rourke, F. (16/09/2017) The downsizing dilemma? Getting rid of the family furniture, The Irish Times, available online at www.irishtimes.com/life-and-style/homes-and-property/the-downsizing-dilemma-getting-rid-of-the-family-furniture-1.3214649

The Challenge of Menopause

By Daniel Miller, on 3 August 2018

Photo (CC BY) Daniel Miller

For a project concerned with health and mid-life, menopause is an obvious target. What specifically does an anthropological perspective add, first to understanding menopause and second to envisaging a positive digital intervention? One key anthropological component, which is the comparative perspective, will have to wait until the team completes its research, but from my Irish fieldsite there are many possible insights. The challenge is firstly that no two women have the same experience. Menopause can start in your 30s or 50s. It can be almost symptom-free or have dramatic effects, some of which may never end.

The anthropologist will focus on the way medical issues are inextricable from the social context. The effect can be on close relationships. As a pharmacist told me, Sometimes they come and say ‘I’m ready to kill my husband I think I’m going crazy’ very reassured when you say it could be the menopause”. Or women report that vaginal dryness makes it too painful to have sex. Women have told me that their mothers never mentioned menopause to them, or that they do or do not feel they can discuss the topic with their sister or close friends. Mostly they report that menopause is a topic that can only be broached through jokes. The impact might also be on wider relationships, such as to one’s work: “You might say to your colleague `could you just take over for a moment’ and then not explain why you would disappear, because you had a flush and you needed to remove yourself”.

Then there is the relation to wider medical authorities. Concerns about HRT or addictive sleeping pills may mean they prefer to consult complementary medicine rather than doctors. Knowledge seems to be a complete lottery, where some are well aware of the potential effects on bone density while others have never had anyone suggest this is something they might look into. Listening to women, within an ethnography, also alerts one to the considerable differences in perspective. One woman will give a feminist perspective about the need to rethink menopause as a celebration of a natural process, rather than merely a medical problem. While another, who is undergoing IVF and is desperate to have children, sees nothing to celebrate.

For us, the ASSA team, it is important that this same alertness to the social and wider context should manifest itself as the anthropological contribution towards delivering that will be of genuine benefit. One of the lessons from this research is that we need to see smartphone apps less as autonomous interventions and more as potential hubs. Different women will respond to different levels of information. There are those who are turned off by text and just want visuals, contrasted to those who want to read the medical journals. In my research so far, women have split equally between those who would prefer a discussion forum based on complete anonymity, to those who would only want to discuss these issues with people they can identity and feel some sort of relation to. In making relevant information more accessible all these factors need to be taken into account, but first and foremost comes listening to what a broad range of women say.